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目的:报告防城港市首例口服脊髓灰质(脊灰)减毒活疫苗引起相关麻痹型脊髓灰质炎(VAPP)病例,为探索控制措施提供依据。方法:对报告的疑似VAPP病例进行流行病学个案调查,采集病例、病例接触者粪便标本进行病毒分离,对病例所在地附近医院开展急性弛缓性麻痹(AFP)病例主动搜索,对病例所在地开展儿童接种率调查。结果:病例为足2月龄首次口服脊髓灰质活疫苗(OPV)35天出现麻痹症状,临床诊断为AFP,最终诊断为服苗者VAPP病例,在防城港是首次发现,属于预防接种异常反应。结论:该儿童有肛周脓肿,为减少和避免VAPP的发生,需加强接种疫苗前病史询问和查体,知情同意和告知工作,并做好记录,对接种首剂OPV的儿童建议使用世界卫生组织(WHO)推荐的脊髓灰质炎灭活疫苗(IPV)或IPV/OPV序贯免疫程序。
OBJECTIVE: To report the first case of VAPP associated with live attenuated oral poliovirus (poliomyelitis) in Fangchenggang City, and to provide a basis for exploring the control measures. Methods: Epidemiological case investigation was conducted on suspected VAPP cases reported. Stool specimens of cases and cases were collected for virus isolation. The cases of acute flaccid paralysis (AFP) were actively searched in the hospitals near the cases and children were vaccinated Rate survey. Results: The paralysis was observed 35 days after the first oral poliovirus (OPV) of 2-month-old oral poliovirus vaccine (OPV). The diagnosis of AFP was clinically diagnosed as VFPP. It was the first time that it was detected in Fangchenggang and was an abnormal response to vaccination. CONCLUSIONS: This child has perianal abscess. To reduce and avoid the occurrence of VAPP, it is necessary to strengthen interrogation and physical examination, informed consent and notification of vaccination history and make a record of the use of World Health for children vaccinated with OPV Organized (WHO) recommended poliomyelitis inactivated vaccine (IPV) or IPV / OPV sequential immunization program.